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The Journal of Bone and Joint Surgery (American) 80:284-98 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Instability of the Shoulder: Complex Problems and Failed Repairs. Part II. Failed Repairs*{dagger}

EVAN L. FLATOW, M.D.{ddagger}, NEW YORK, ANTHONY MINIACI, M.D., F.R.C.S.(C)§, PETER J. EVANS, M.D., PH.D., F.R.C.S.(C)§, TORONTO, ONTARIO, CANADA, PETER T. SIMONIAN, M.D.# and RUSSELL F. WARREN, M.D.#, NEW YORK, N.Y.

An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons

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   Introduction
 
Most patients who have instability of the shoulder can be well managed non-operatively. When such treatment fails, modern anatomical repairs achieve stability and function in a high proportion of patients. When these goals are not achieved, patients and surgeons are considering a revision operation with increasing frequency. A repair for instability may fail because of incorrect diagnosis, improper operative technique, or inappropriate rehabilitation2. These complex situations represent both a diagnostic challenge to pinpoint the etiology of the failure of the first repair and a technical challenge to reconstruct the shoulder in the face of scarring and anatomical distortion from a previous procedure. Although there is considerable overlap, it can be helpful to broadly group these patients according to the outcome of the primary procedure. These groups consist of those who have recurrent instability, those who have a stiff or overly tight shoulder, and those who have an arthrotic shoulder40. . . [Full Text of this Article]


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